Provider Enrollment Specialist

University of Utah Health•Salt Lake City, UT

63d

About The Position

The Provider Enrollment Specialist obtains and coordinates provider enrollment applications required for billing Medicare, Medicaid, and contracted insurance payers. The role supports the maintenance of physician group and individual physician records and helps ensure regulatory and hospital contract compliance. It prepares and maintains enrollment documents and provider information, communicates with providers and fiscal intermediaries, and works enrollment issues and provider enrollment claims in Epic. The specialist follows department, organizational, and insurance payer guidelines and reports detected problems, errors, or changes in enrollment requirements.

Requirements

Associate's degree in a related area of assignment, or equivalency.
Three years of experience in professional support.
Excellent written and verbal communication and customer service skills, including professional telephone skills.
Good organizational skills and attention to detail.
Self-motivation and good time-management and organizational skills.
Ability to read and interpret basic to moderately complex documents, including operating and maintenance instructions, procedure manuals, and government or healthcare guidelines.

Nice To Haves

Provider Enrollment experience.
Ability to multitask in a busy office environment.
Experience with Epic and Cactus system applications.

Responsibilities

Prepare documents necessary to enroll physicians and non-physician providers with insurance carriers.
Maintain additions, deletions, and changes to the Physician Enrollment file, including reviewing payer membership.
Handle telephone communications and written correspondence with providers and fiscal intermediaries to facilitate the Provider Enrollment process.
Maintain updated information according to insurance carrier requirements by contacting carriers and reviewing bulletins and other materials sent to providers.
Work with the team on projects such as new start-ups, renewals, and re-credentialing applications required by insurance carriers.
Prepare documents consistently and accurately.
Communicate information for input into Cactus and Epic, including new providers and updates to provider information using the appropriate forms.
Work enrollment issues.
Work provider enrollment claims in Epic.
Follow department and insurance payer guidelines when preparing documents.
Report detected problems, errors, or changes in provider enrollment requirements.
Comply with department and organization policies and insurance carrier guidelines.
Perform other duties as assigned.